Adolescent Anemia: Model Clinical Case and Viva QnA

Clinical Case of Adolescent Anemia

Sarah, a 15-year-old female, presents to her pediatrician with complaints of fatigue, weakness, and occasional dizziness for the past two months. She reports difficulty concentrating in school and has recently quit the track team due to exhaustion. Sarah's mother notes that her daughter has become increasingly pale and irritable.

Medical History:

• Menarche at age 12
• Heavy menstrual periods lasting 7-8 days
• Vegetarian diet for the past year
• No known chronic illnesses
• No recent illnesses or injuries

Physical Examination:

• Weight: 50 kg (10th percentile)
• Height: 160 cm (25th percentile)
• Blood Pressure: 110/70 mmHg
• Pulse: 92 bpm
• Pale conjunctiva and nail beds
• Slight tachycardia
• No hepatosplenomegaly

Laboratory Results:

• Hemoglobin: 9.2 g/dL (Normal: 12.0-15.0 g/dL)
• Hematocrit: 28% (Normal: 36-46%)
• MCV: 75 fL (Normal: 80-96 fL)
• Ferritin: 8 ng/mL (Normal: 12-150 ng/mL)
• Peripheral blood smear: Microcytic, hypochromic red blood cells

Based on the clinical presentation, physical examination, and laboratory results, Sarah is diagnosed with iron-deficiency anemia. The pediatrician recommends iron supplementation, dietary counseling, and follow-up to monitor her response to treatment.

Click to read Classification of anemia in pediatrics

Clinical Presentations of Adolescent Anemia

Clinical Presentations of Adolescent Anemia

1. Iron-Deficiency Anemia:
   • Fatigue and weakness
   • Pale skin, conjunctiva, and nail beds
   • Shortness of breath with exertion
   • Pica (craving for non-food items)
   • Spoon-shaped nails (koilonychia)
   • Restless leg syndrome
2. Thalassemia:
   • Pallor and jaundice
   • Fatigue and exercise intolerance
   • Growth retardation
   • Hepatosplenomegaly
   • Skeletal changes (frontal bossing, maxillary hypertrophy)
3. Sickle Cell Anemia:
   • Recurrent pain crises
   • Fatigue and pallor
   • Jaundice
   • Delayed growth and sexual maturation
   • Increased susceptibility to infections
4. Vitamin B12 Deficiency Anemia:
   • Fatigue and weakness
   • Pale or jaundiced skin
   • Shortness of breath
   • Neurological symptoms (tingling or numbness in extremities)
   • Mood changes or depression
5. Folate Deficiency Anemia:
   • Fatigue and weakness
   • Pale skin
   • Irritability
   • Smooth, red tongue
   • Diarrhea
6. Aplastic Anemia:
   • Fatigue and pallor
   • Frequent or prolonged infections
   • Easy bruising or bleeding
   • Petechiae or purpura
   • Shortness of breath with exertion
7. Hemolytic Anemia:
   • Jaundice
   • Dark urine
   • Fatigue and pallor
   • Abdominal pain
   • Leg ulcers (in some chronic cases)
8. Lead Poisoning-Induced Anemia:
   • Abdominal pain and constipation
   • Irritability and behavioral changes
   • Fatigue and weakness
   • Cognitive impairment
   • Blue-black lines on gums (Burton lines)

Knowledge Check: Question and Answers for Medical Students & Professionals

This interactive quiz component covers essential viva questions and answers. It includes 30 high-yield viva questions with detailed answers.

Question 1 of 30

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